Miscarriage is the sudden, unexpected loss of pregnancy before reaching the 20th week. This happens when the foetus does not develop as expected and terminates early in pregnancy.
It is reported that nearly 8 out of 10 miscarriages occur in the first trimester.
It may not be easy to tell whether it is a miscarriage or a period. In fact, early pregnancy loss can happen even before you are aware of the pregnancy. You may not notice anything unusual.
Miscarriages are typically beyond your control. They don’t occur because of something you did.
Everyday activities like exercising, routine work, sexual intercourse, or travel do not result in a miscarriage. It is primarily caused due to genetic problems, health issues like severe diabetes or infections, major injuries, or previous miscarriages. An annual gynaecological exam can significantly reduce these risk factors. And it can all start with taking the first step and scheduling an appointment with an expert. Are you interested in finding out how to handle your first consultation? Then you can refer to our First Visit Guide, it should help you prepare for the appointment.
A] What are the Signs & Symptoms?
The early signs of miscarriage are bleeding & menstrual cramps. Vaginal bleeding is often the most common sign that appears & disappears frequently. There can be a dark brown discharge or heavy bleeding. But light bleeding is common during the first three months and should not be a cause of concern. Visit your doctor immediately if there is heavy bleeding in miscarriage.
The other common important women’s health symptoms of miscarriage are:
- Pelvic pain or cramps in the lower abdomen
- Lower back pain
- Nausea or Diarrhoea
- Discharge of fluid or tissue from the vagina
- Absence of pregnancy symptoms like sickness or breast tenderness
Signs & symptoms usually depend on the stage of pregnancy. A foetus at 16 weeks is much larger than that at six weeks. The blood and tissue loss will be more at a later stage. But the period vs miscarriage dilemma will abate as you proceed further along your pregnancy. The symptoms may also vary among people due to their physical condition.
B] What are the Different Bleeding Types & Patterns?
A miscarriage can occur anytime after the fertilisation process. You would not be able to know the difference between a miscarriage and a period if you were not aware of the pregnancy. But you would rarely confuse a miscarriage for a period after eight weeks.
When a pregnancy loss happens during the first five weeks (chemical pregnancy), the early miscarriage tissue may not be visible to the naked eye. The embryo has formed, but it stops developing. It happens so early that you may not be aware of the miscarriage at all. It can just resemble menstrual periods.
Women very well know the length of their period. But the bleeding is severe and lasts longer in a miscarriage. Cramps get more painful, and bleeding gets heavier as the cervix begins to dilate.
Heavy bleeding while pregnant around the time of your period is more likely a sign of miscarriage. It generally stops within 3-5 hours. Light bleeding can occur over 1-2 weeks and then stop completely. The blood can appear brown, pink, or bright red. It can also take the colour of coffee grounds.
- Closely notice the bleeding pattern. If it gets progressively heavier, it is a clear sign of miscarriage.
- Watch out for cramps that appear to have a regular pattern.
- Some people may also experience large miscarriage blood clotsin a pregnancy loss beyond six weeks.
C] How Long Does the Bleeding Last?
The duration varies from person to person and generally depends upon the stage of pregnancy. Miscarriages that occur in the initial weeks may result in bleeding for a few days. But the matter gets serious as the pregnancy progresses. Bleeding may continue for up to 4 weeks in the later stages. It may stop and start all over again before getting lighter.
Doctors usually prescribe misoprostol (Cytotec) medication for miscarriages. Bleeding starts within a day or two of getting on the medication. After the miscarriage, the heaviest bleeding occurs in about 3-5 hours. Spotting and tissue loss may be seen for 1-2 weeks. It may take around two weeks for the miscarriage to pass through naturally.
D] Difference Between Miscarriage & Periods
How do you know that the heavy bleeding is due to miscarriage and not the regular period?
Around 75-80% of miscarriages occur in the first 12 weeks, even before the woman is aware of the pregnancy. This may often result in miscarriage bleeding, which may be confused for a period since the symptoms are very similar. Both involve bleeding and cramps. The tissue discharge from the vagina is similar to a blood clot that occurs during menstruation.
But a pregnancy loss is usually associated with additional symptoms that are more intense than a regular period. These differences are more prominent when miscarriages occur during the later stages of pregnancy. These symptoms are as follows:
- Bleeding is heavier and lasts longer than a typical period.
- The difference between miscarriage and period clotsis that the former is much larger.
- Chemical pregnancy results in heavy bleeding and often resembles a late or heavy period.
- Cramps in the lower abdomenduring miscarriages are more painful as the cervix starts to dilate. To understand more about cramps, you can refer to our pelvic pain pregnancy guide.
- Strong pain in the lower back and the pelvis region also points to pregnancy loss rather than a period.
- Heavy bleeding along with severe pain in the abdomen could be a sign of ectopic pregnancy, where the fertilised egg implants outside the uterus.
- The blood colour during a miscarriage is different from what you see during a menstrual period. Clear or pink fluid is often passed during a miscarriage.
- Sudden loss of pregnancy symptoms like nausea or breast tenderness.
In general, the intensity of the symptoms you experience can indicate whether you have a miscarriage or a heavy period. Heavy bleeding, tissue pieces, or large blood clots often indicate that it’s not simply a sudden heavy period.
E] What is a Missed Miscarriage?
A missed miscarriage is also called a silent miscarriage or a missed abortion. It occurs when the baby has died in the womb, but the mother does not experience any symptoms such as pain, bleeding, or discharge of foetal tissue. It is subsequently revealed through an ultrasound which shows no foetal heartbeat.
With a missed miscarriage, although the pregnancy begins right the foetus stops developing, and the heartbeat also stops sometime during the 6-10 weeks. Silent miscarriages are mostly attributed to chromosomal abnormalities that prevent the progress of a pregnancy. In some cases, the embryo does not develop and leaves an empty sac.
Missed miscarriages account for nearly 1-5% of all pregnancies. Heavy bleeding in miscarriage is this type of miscarriage is absent. But some women do notice the disappearance of their pregnancy symptoms, such as nausea, fatigue, or breast tenderness. A brownish discharge may be seen sometimes.
F] Treatment of Missed Miscarriages
Doctors generally provide the following three options to women who experience a missed abortion:
- Surgical treatment to remove the pregnancy
- Medication to expedite the miscarriage
- Awaiting a natural miscarriage in due course of time (bleeding & cramps may start on their own)
G] When Is It Safe To Try Again To Conceive?
Miscarriages are physically painful and emotionally draining too. The couple may experience intense feelings of sadness, guilt, and anxiety simultaneously. It is better to give yourself ample time to cope and not rush the grieving process with an immediate pregnancy.
Sexual intercourse is not recommended for about 15 days after miscarriage to prevent infections. Doctors generally advise couples to wait for at least one menstrual cycle before planning the next pregnancy. Plan the next step only after you feel physically & emotionally ready to take the plunge again.
Women who have experienced two or more miscarriages have to be extra cautious. The following tests may be recommended by your doctors if you have suffered multiple miscarriages:
- Chromosomal Tests
- Blood Tests
It is important to stay strong and not lose hope if you experience a miscarriage. Most women go on to have healthy pregnancies despite suffering multiple miscarriages. Adopt a healthy lifestyle and quit smoking & consuming alcohol. A daily dose of prenatal vitamin supplement for 2-3 months before conception can be helpful.
H] What Are The Chances Of This Happening Again?
Miscarriage is usually a one-off event, and fortunately, most women will have healthy pregnancies in the future. About 2% of pregnant women experience two consecutive miscarriages. Just 1% of pregnant women have recurrent (3 or more) pregnancy losses. Some women may experience heavy bleeding in miscarriages and loss of tenderness in their breasts.
The probability of repeated miscarriages is extremely minimal. Research studies report that about two-thirds of women who have suffered recurrent miscarriages will have a safe & healthy pregnancy without availing of any medical treatment. But the risk of recurrent miscarriage increases after the age of 35.
It occurs mostly due to genetic abnormalities. Smoking, alcohol, and caffeine can increase the chance of miscarriages and should be avoided.
I] In A Nutshell
Pain and bleeding are common after a miscarriage. Heavy bleeding during early pregnancy appears similar to a period and should typically stop within some time. Normal painkillers should suffice to manage the pain, however, there are also other ways to stop heavy periods and manage them. You should consider avoiding sex when faced with sudden heavy periods and use sanitary pads.
If the miscarriage has started, it cannot be prevented later. Treatment can only prevent heavy bleeding and infections. You should seek medical attention if you have the following:
- Pain and bleeding that is more intense than in a regular period
- A vaginal discharge with a strange, obnoxious odour
- Fever, dizziness, or diarrhoea
The pregnancy tissue should pass out naturally in a week or two. In case of any difficulty, suitable medications or minor surgery may be recommended by your doctor. An ultrasound may be advised by the doctor to confirm that the tissue has been cleared from the uterus.
If you want answers to all your queries about women’s health that you can’t ask anyone, our Well Woman Clinic is a perfect choice.
We offer convenient access to preventive healthcare solutions for women of all ages, from adolescence to women dealing with menopause. If you want to learn more about heavy periods and how they can affect your fertility, then you can refer to our guides, reasons for heavy periods and causes of infertility. However, if you are looking for treatments, you should not hesitate to reach out to us. We deliver a wide range of best-in-class gynaecological & obstetric services.
A well-woman checkup helps you spot the risk factors early to prevent any kind of complication. Make it a part of your routine to provide the best care for yourself. Schedule a visit to our centre without any delay. Our checkups are customised to your age & medical condition.
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